Naproxen is one of our most commonly dispensed medicines at Pharmacy2U. It’s a medicine which is used to help treat pain and inflammation in the muscles and joints. Here I’m going to outline the most important considerations for anyone who’s starting to take Naproxen including how it works, how it’s taken, and other precautions you’ll need to consider.
What is Naproxen and how does it work?
Naproxen belongs to a group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs) and it’s used to help relieve inflammation and treat pain in the muscles and joints. Other common NSAIDs include ibuprofen and diclofenac, which are used for the same conditions, however naproxen has been shown to have a slightly lower risk of longer term side effects than other NSAIDs.
NSAIDs work by blocking the effect of an enzyme in the body called cyclooxygenase (COX), which is involved in the production of other chemicals called prostaglandins – these are involved in the production of inflammation and pain at sites of injury or damage; so by reducing their production, inflammation can be relieved.
What conditions does Naproxen treat?
Naproxen is prescribed to help diseases of the joints such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Although it can’t cure arthritis, it can be used to help relieve its symptoms (including inflammation, swelling, and stiffness). Naproxen can also be prescribed to aid in the treatment of gout. It’s also used to help treat muscle pain and disorders, as well as painful periods – menstrual cramps can be relieved by the reduction in prostaglandins that NSAIDs produce.
For adults being treated for Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis:
- 500mg to 1g a day, taken in 2 doses at twelve hour intervals. If 1g is needed it can be given as a single dose, or as two 500mg doses.
For adults being treated for an acute attack of gout:
- Initially you’re likely to take 750mg as a single dose, followed by further doses of 250mg every eight hours until the attack has passed.
For adults being treated for painful periods and disorders of the muscles and bones:
- An initial dose of 500mg is usually taken, followed by a further dose of 250mg every six to eight hours, as required. After the first day, the maximum daily dose is 1250mg.
The dosages above may be reduced for elderly patients, or may be tailored for you by your doctor.
How should I take Naproxen?
Naproxen is a prescription-only medicine which comes in several different forms, including:
- Normal tablets
- Effervescent tablets – these must be dissolved in water before you take them, and start working quickly
- Gastro-resistant tablets – these have a special coating to prevent stomach irritation
- Oral suspension – a liquid form which may be preferred if there are swallowing difficulties
If you’re taking effervescent tablets, one or two should be dissolved in 150ml of water before drinking. Doses of three tablets should be dissolved in 300ml of water. It should be taken with or immediately after food.
If you’re taking gastro-resistant tablets, they should be swallowed whole, with or just after food. Don’t crunch or chew them, as this would break the coating that protects the stomach from irritation.
What are the side effects associated with Naproxen?
Like taking any medicine, there may be some side effects associated with taking Naproxen, but not everybody gets them.
The following side effects are common, and may pass with time. Inform your doctor if they are causing problems or if they persist:
- Confusion
- Headache
- Ringing in the ears
- Changes in vision (you should also go for an eye test if you notice changes in vision)
- Tiredness
- Drowsiness
- Dizziness
Stop taking Naproxen immediately and contact your doctor if you encounter any of the following side effects:
- Heartburn, indigestion, stomach pains or other abnormal stomach symptoms, feeling nauseous or vomiting, diarrhoea, worsening of colitis and Crohn’s disease (you may have an ulcer or inflammation in the stomach or gut).
- Passing blood in your faeces (stools/motions) or black tarry looking stools (signs of bleeding and perforation of the stomach and intestines).
- Vomiting any blood or dark particles that look like coffee grounds.
- Symptoms that could indicate an allergic reaction, including
- Swelling of the face, mouth, tongue, airways or body.
- Skin reactions including: hives (pale/red raised skin with severe itching), blistered skin, itchy skin rash, blood spots, bruising or discolouring of the skin, raised purple rashes, red skin patches, a severe rash with reddening, peeling and swelling of the skin that resembles burns, bumpy, rashes, blisters, dermatitis (skin shedding, itching, swelling).
- Difficulty breathing or wheezing, or coughing up blood.
What other drugs does Naproxen interact with?
You must tell your doctor if you’re taking or have recently taken any of the following medicines when you are prescribed Naproxen:
- Aspirin, to prevent blood clots
- Any other NSAID medicines
- Medicines which thin the blood or which prevent blood clotting (e.g. Heparin or Warfarin)
- Corticosteroids (e.g. Prednisolone); if needed the doctor will reduce the dose of the steroid slowly and monitor for side effects
- Diuretics, known as “water tablets” (e.g. Furosemide)
- Medicines to treat high blood pressure (e.g. Captopril, Ramipril or Propranol, Losartan or Candesartan)
- The immunosuppressant drugs Ciclosporin or Tacrolimus
- MifepristoneSSRI antidepressants, such as Fluoxetine, Citalopram, or Sertraline
- Zidovudine
- Quinolone antibiotics (e.g. ciprofloxacin)
- Probenecid
- Methotrexate
- Bisphosphonates
- Cholestyramine Lithium
- Phenytoin
- Sulfonamides (e.g. sulfamethoxazole)
- Sulfonylureas (e.g. glibenclamide or gliclazide)
- Cardiac glycosides (e.g. digoxin)
Can I take Naproxen with alcohol?
You can drink alcohol in moderation when taking Naproxen, but if you drink too much it may irritate your stomach.
How long does it take for Naproxen to work?
You should start feeling the effects of Naproxen around 1 hour after taking it. However, it can take up to 3 days for it to start working properly if it’s being taken twice a day on a regular basis.
Taking Naproxen during pregnancy or while breastfeeding
Naproxen should not be taken during pregnancy, unless your doctor considers it essential; and even then, only within the first 6 months.
Naproxen contraindications (precautions)
Naproxen isn’t suitable for everyone. You should tell your doctor or pharmacist if any of the following apply to you:
- If you’ve had an allergic reaction to Naproxen or any other medicines in the past
- If you’ve had an allergic reaction to aspirin or other non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen
- If you have or have had stomach ulcers, or bleeding in the stomach or intestines
- If you have high blood pressure
- If you have severe liver or kidney failure
- If you have severe heart failure or other heart problems
- If you have Crohn’s disease or ulcerative colitis
- If you have lupus
- If you have a blood clotting disorder
- If you are pregnant, planning to become pregnant, or breastfeeding
Sources of information
If you have any more questions about Naproxen, you can talk to your pharmacist, or try these links for more general information.
To report side effects from Naproxen, or from any other prescribed medicine, you can use the following link:
